急性开始的术后疹内膜炎:一个病例报告
Vinita Gupta1, Umesh Yadav1, Saurabh Luthra2
1Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.
Cureus
|July 26, 2023
概括
简单疹病毒可以在白内障手术后引起急性内炎,即使没有角膜重新激活. 在这些罕见病例中,早期怀疑和用口服瓦拉基克洛维尔治疗对于积极的结果至关重要.
科学领域:
- 眼科医生 眼科 眼科
- 病毒学 病毒学
- 传染性疾病 传染性疾病
背景情况:
- 简单疹病毒 (HSV) 是已知的脑膜炎的原因,但其在白内障手术后急性术后内炎中的作用未得到报道.
- 手术后内炎通常在手术后2-7天出现,细菌感染是最常见的原因.
研究的目的:
- 在白内障手术后72小时内出现的一种罕见的急性发生疹内炎病例.
- 强调在术后内炎中考虑病毒原因,特别是HSV的重要性,当细菌和真菌培养物呈阴性时.
主要方法:
- 一名55岁的患有复杂白内障的男性患者接受了白内障手术,手术内进行了后部囊裂和前部玻璃切除.
- 手术后的炎症用内抗生素治疗,但症状恶化.
- 在水和玻璃样本上的聚合酶链反应 (PCR) 证实了疹病毒DNA,导致用口服瓦拉基克洛维尔治疗.
主要成果:
- 患者在术后第三天出现了严重的前腔炎症和玻璃体雾.
- 玻璃体样本的细菌和真菌培养是负的.
- 用口服瓦赛克洛维尔治疗导致眼部炎症的解决.
结论:
- 简单疹病毒内炎在白内障手术后,即使没有先前的角膜重新激活,也会急性发生.
- 临床医生应在急性术后内炎没有响应标准抗生素治疗的情况下保持对病毒内炎的高度怀疑.
- 早期诊断和抗病毒疗法对于管理疹内耳炎是必不可少的.
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